POUDRE VALLEY MEDICAL GROUP, LLC (NPI# 1942815253) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1942815253 |
| Entity Type | Organization |
| Organization Name | POUDRE VALLEY MEDICAL GROUP, LLC |
| Practice Address |
4110 Briargate Pkwy Ste 460 Colorado Springs CO 80920-7839 |
| Mailing Address |
2695 Rocky Mountain Ave Ste 150 Loveland CO 80538-9071 |
| Practice Telephone | 7193648347 |
| Practice Fax Number | 7193648346 |
| Mailing Telephone | 7193648347 |
| Mailing Fax Number | 7193648346 |
| Enumeration Date | 2020-09-14 |
| Last Update Date | 2020-09-14 |
| Authorized Official Name | JANA CONROY (CREDENTIALING MANAGER) |
| Authorized Official Telephone | 9706244443 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208600000X | Surgery | Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| UCHealth Surgical Clinic - Memorial Hospital North | Other Name - Individual/Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396350476 | Poudre Valley Medical Group, LLC | Urology | 2315 E Harmony Rd Ste 140, Fort Collins, CO 80528-8620 | 2020-09-15 |
| 1699389353 | Poudre Valley Medical Group, LLC | Internal Medicine | 5818 N Nevada Ave, Suite 225, Colorado Springs, CO 80918 | 2020-09-01 |
| 1700490455 | Poudre Valley Medical Group, LLC | Radiology | 4080 Briargate Parkway, Colorado Springs, CO 80920 | 2020-09-01 |
| 1134732209 | Poudre Valley Medical Group, LLC | Physical Medicine & Rehabilitation | 5818 N Nevada Avenue, Suite 225, Colorado Springs, CO 80918 | 2020-08-28 |
| 1104439322 | Poudre Valley Medical Group, LLC | Radiology | 525 Bob Peters Grv Ste 100, Colorado Springs, CO 80909-4533 | 2020-08-27 |
| 1932712155 | Poudre Valley Medical Group, LLC | Internal Medicine | 940 Central Park Dr Ste 290, Steamboat Springs, CO 80487-8853 | 2020-08-27 |
| 1033722376 | Poudre Valley Medical Group, LLC | Family Medicine | 15854 Jackson Creek Pkwy Unit 120, Monument, CO 80132-8663 | 2020-08-26 |
| 1285247866 | Poudre Valley Medical Group, LLC | Physical Therapist | 6767 29th St Fl 1, Greeley, CO 80634-5474 | 2020-08-25 |
| 1932711868 | Poudre Valley Medical Group, LLC | Obstetrics & Gynecology | 100 Cook St Ste 210, Denver, CO 80206-5328 | 2020-08-21 |
| 1619586187 | Poudre Valley Medical Group, LLC | Urology | 175 S Union Blvd Ste 315, Colorado Springs, CO 80910-3126 | 2020-07-30 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Colorado Business Entities | Poudre Valley Medical Group, LLC | 2695 Rocky Mountain Ave., Suite 110, Loveland, CO 80538 |
| Street Address |
4110 BRIARGATE PKWY STE 460 |
| City | COLORADO SPRINGS |
| State | CO |
| Zip Code | 80920-7839 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316917909 | Margaret Moore Morgan | Surgery | 4110 Briargate Pkwy Ste 460, Colorado Springs, CO 80920-7839 | 2006-01-25 |
| 1831307438 | Vishal Rana | Internal Medicine | 4110 Briargate Pkwy Ste 460, Colorado Springs, CO 80920-7839 | 2007-05-18 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407463409 | Cynthia Cruz | Marriage & Family Therapist | 7710 N. Union, Ste 100b and 100c, Colorado Springs, CO 80920 | 2020-09-24 |
| 1851905178 | Emergency Medical Specialists, PC | Emergency Medicine | Woodmen Fsed - Md, 3790 E. Woodmen Road, Colorado Springs, CO 80920 | 2020-09-03 |
| 1114531431 | Emergency Medical Specialists, PC | Emergency Medicine | Memorial Hospital North - Md, 4050 Briargate Pkway, Colorado Springs, CO 80920 | 2020-09-03 |
| 1205440583 | Emergency Medical Specialists, PC | Emergency Medicine | Memorial Hospital North - App, 4050 Briargate Pkway, Colorado Springs, CO 80920 | 2020-09-03 |
| 1700490455 | Poudre Valley Medical Group, LLC | Radiology | 4080 Briargate Parkway, Colorado Springs, CO 80920 | 2020-09-01 |
| 1962015792 | Emergency Medical Specialists, PC | Emergency Medicine | Woodmen Fsed - App, 3790 E. Woodmen Road, Colorado Springs, CO 80920 | 2020-08-31 |
| 1194296491 | Kramer Dentistry Inc | Clinic/Center | 9290 Highland Ridge Heights Suite # 120, Colorado Springs, CO 80920 | 2018-12-12 |
| 1134602279 | Juliana Plucinik | Assistant Behavior Analyst | 7011 Campus Drive Suite 205, Colorado Springs, CO 80920 | 2018-09-14 |
| 1811473861 | Vsb Colorado Providers Pllc | Dentist | 1750 Telstar Drive, Suite 200, Colorado Springs, CO 80920 | 2018-07-12 |
| 1336637438 | Children's Hospital Colorado | General Acute Care Hospital | 4090 Briargate Parkway, Colorado Springs, CO 80920 | 2018-04-25 |
| Find all providers in zip 80920 | ||||
| Taxonomy Code | 208600000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Surgery |
| A general surgeon has expertise related to the diagnosis - preoperative, operative and postoperative management - and management of complications of surgical conditions in the following areas: alimentary tract; abdomen; breast, skin and soft tissue; endocrine system; head and neck surgery; pediatric surgery; surgical critical care; surgical oncology; trauma and burns; and vascular surgery. General surgeons increasingly provide care through the use of minimally invasive and endoscopic techniques. Many general surgeons also possess expertise in transplantation surgery, plastic surgery and cardiothoracic surgery. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Surgery, 2007. http://www.absurgery.org/. American Osteopathic Board of Surgery, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Surgery. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Surgery. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780217398 | Healthone Clinic Services - Bariatric Medicine LLC | Surgery | 6965 Tutt Blvd Ste 200, Colorado Springs, CO 80923-3598 | 2020-02-21 |
| 1801156856 | Jeremy Hedges Md, Mph, LLC | Surgery | 1715 N Weber St Ste 220, Colorado Springs, CO 80907-7553 | 2012-05-24 |
| 1427373307 | Daniela Botolin | Surgery | 6071 E Woodmen Rd Ste 340, Colorado Springs, CO 80923-2612 | 2010-04-02 |
| 1427192855 | James M Larkin | Surgery | 61 W Boulder St, Colorado Springs, CO 80903-3371 | 2007-02-18 |
| 1518045905 | Patrick I Burns | Surgery | 4110 Briargate Pkwy Ste 140, Colorado Springs, CO 80920-7836 | 2006-11-01 |
| 1386651891 | Ed A Schmitt | Surgery | 4130 Three Graces Dr, Colorado Springs, CO 80904-4607 | 2006-08-01 |
| 1891739058 | Richard M Malyszek | Surgery | 2222 N Nevada Ave Ste 5017, Colorado Springs, CO 80907-6865 | 2006-06-16 |
| 1750359642 | Robert Todd Wilcox | Surgery | 4810 Rusina Rd Ste B, Colorado Springs, CO 80907-8104 | 2006-03-08 |
| 1568438026 | Lisa Maxwell | Surgery | 675 Coveglen Ct, Colorado Springs, CO 80906-6801 | 2006-02-24 |
| 1316917909 | Margaret Moore Morgan | Surgery | 4110 Briargate Pkwy Ste 460, Colorado Springs, CO 80920-7839 | 2006-01-25 |
| Find all providers in COLORADO SPRINGS | ||||
| City | COLORADO SPRINGS |
| Zip Code | 80920 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.